another question for school, would really appreciate feedback...

Specialties Ob/Gyn

Published

Specializes in OB, lactation.

"Describe the upper limits of bilirubin levels in your hospital or affiliated institution before treatment is started. How is the bilrubin tested? Do they use BilChek to screen for bilirubin. Do they use CO-Stat End-Tidal Breath Analyzer to screen for hemolysis? Also describe protocols for treatment for jaundice of the healthy full-term infant and the low-birth weight infant."

Thanks VERY much for feedback!!

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Hi there!

We are a level I nursery so we have healthy full term babes. We do all our bili testing with heelsticks. All of our babes get a discharge bili level done as a baseline. We treat based on their age.

24-48 hours bili >15

48-72 hours bili >18

>72 hours bili >20

If they have an elevated bili we also do type & coombs, cbc, and urine for reducing substances (glucose).

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All of our babes get a discharge bili level done as a baseline.

All of your babies get bilis? That seems like overkill. Are there many others here whose hospitals do that?

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We only started testing all babes recently. The AAP came out with new recommendations about preventing hyperbilirubinemia and this is one of the recommendations. We do it with the NB screen to save an extra heelstick. I think it is overkill also but that's what our docs wanted. Our practices pretty much coincide with what the AAP says.

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We only started testing all babes recently. The AAP came out with new recommendations about preventing hyperbilirubinemia and this is one of the recommendations.

Wow--I hadn't read that yet. I knew the AAP had some new recommendations out, but I didn't realize they recommended testing every baby.

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Specializes in OB, lactation.

Thanks!

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Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.
All of your babies get bilis? That seems like overkill. Are there many others here whose hospitals do that?

{waves to Heather}

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

Yes, kernicterus screening on all newborns is going to be a standard of care at the hospitals for all babies very soon. We are starting where I work in the very near future. And it will be done transcutaneously, not via heel stick, unless the need really arises.

Here is an article from USA TODAY regarding Kernicterus:

http://www.usatoday.com/news/health/2001-05-02-testing-newborns.htm

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